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Newcastle figures question reporting of dental emergencies

Accident and Emergency entrance of St Thomas' Hospital in central London. (Photograph: BasPhoto/Shutterstock)
Dental Tribune International

Dental Tribune International

Thu. 12 January 2017

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LONDON, UK: With NHS trusts in crisis all over Britain, new estimates by Newcastle University’s Centre for Oral Health Research have indicated that a much higher number of people in the UK may present to medical emergency departments with dental problems than commonly believed. According to the three-year study, which looked at coded A & E attendance data from the Newcastle upon Tyne Hospitals NHS Foundation Trust, almost 1 per cent of all emergencies were people with some form of dental problem.

Putting these figures in a national context, the results suggest that ten times more people with dental complaints are visiting emergency departments than indicated in official government figures. While the latter estimated the number of dental emergencies to be 15,000 in 2014/2015, it could actually be almost 150,000, adding to the already huge pressure that A & E departments face in the UK.

Calculations by the British Dental Association have suggested that the additional burden amounts to £15–16 million per year for trusts, which are also not equipped to deal with many of these problems.

“If you experience toothache without significant other symptoms, then heading to a hospital’s A&E department isn’t always necessarily the best option. Ensuring that patients are treated in the right place, at the right time, by the right team is essential for both the patient and the wider public, not just to ensure appropriate diagnosis and treatment but also to reduce unnecessary care and personal costs,” said lead author of the study Dr Justin Durham, who also works as an honorary consultant at Newcastle upon Tyne Hospitals NHS Foundation Trust. “This paper, and other recently published data from Newcastle University’s Orofacial pain research team, suggest there are potentially significant problems in the care pathways both for toothache, and also the group of conditions that cause persistent mouth and face pain such as Temporomandibular Disorders and Trigeminal Neuralgia.”

“We are seeing patients who need our care pushed towards medical colleagues who aren’t equipped to treat them. As long as government keeps slashing budgets, and ramping up charges we will keep seeing more of the same,” added Dr Henrik Overgaard-Nielsen, Chair of the British Dental Association’s General Dental Practice Committee, on the figures.

“GPs and A&E medics are having to pick up the pieces, while government’s only strategy is to ask our patients to pay more in to plug the funding gap,” he also said.

Overall, there were 2,504 visits to the trust’s A & E department owing to dental complaints and 10 per cent of these were by patients who had attended the department for dental problems before. No information was given regarding the reasons people seek such emergency services, but the researchers said that access, financial barriers to treatment or dental anxiety could be contributing factors.

The study, titled “Dental pain in the medical emergency department: A cross-sectional study”, was published on 16 December in the Journal of Oral Rehabilitation ahead of print.

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